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Becoming a parent in the NICU

You've had a premature or sick baby. If your baby was premature, most likely you are still reeling from the shock of your baby's arrival weeks or months before your due date. You may never have fully adjusted to being pregnant, much less being a new parent. You may feel distant from your baby--and the busy, hectic newborn intensive care unit (NICU) environment doesn't make it any easier. But this is an important time for you and your baby to get to know each other and for you to gradually take on your role as mom or dad.

Coping with the NICU roller coaster

For many families, a baby's NICU stay is like a roller coaster ride, with ups and downs, triumphs and setbacks. Of course, the parents are also along for the ride. The following tips can help you deal with your baby's ups and downs.

Give yourself permission to cry and feel overwhelmed. You may be concerned that if you let your feelings flow, you’ll never be able to pull yourself back together. But you will. Allow yourself to feel this release of emotion.

Establish a routine. Find a way to balance work, home life and visiting the hospital. Allow yourself to leave your baby's side when you are comfortable doing so. Your baby needs you, but it's also important to have time for yourself, with your partner and with your other children. Also take time to do things you enjoy, such as exercise. These restful breaks will help you find the strength to keep going.

Connect with other NICU parents. These parents share many of your feelings and struggles. Share your experiences, informally or in a support group. Ask NICU staff if there are graduate NICU parents with whom you can connect for support.

You also can connect with others who understand what you’re going through at the March of Dimes website, Share Your Story. This online community was created especially for families who have faced the frightening experience of having a baby born early or with a health condition. You can ask questions, participate in online chats, share your own story by creating a blog, and read about other babies with similar health challenges.

Explore your spiritual side. It might be helpful for you to reflect and lean on your personal spiritual perspective. You may find comfort speaking with a pastor, priest, rabbi, minister or imam. It is normal for this experience to challenge your religious and spiritual beliefs. In any case, remember that prayer, meditation or quiet reflection can help you find emotional strength and hope, and can guide you through this challenging time.

Keep a journal. Expressing your feelings on paper can help you cope with and move through them. A journal also strengthens your hope and patience, by reminding you how far you and your baby have come.

Vent your frustrations. If your baby has a setback, you may be plunged back into fear and anxiety. Voice your fears, and hope for the best.

Celebrate when you can. When your baby makes progress, dare to experience the joy.

Accept the support of others, however clumsy it may seem. Let people know how they can best help you.

Accept that you and your partner will react differently. Share your experiences and listen with empathy so that you can feel supported.

Building your confidence

It's only natural to feel anxious and unsure about taking care of your tiny baby while hospitalized in the NICU. Here are some suggestions to help you feel more confident as a parent in the NICU:

If this is your first baby, remind yourself that all new parents feel anxious and unsure. Of course, these feelings are more intense because you have a baby in the NICU, but they are also a natural part of being a first-time parent.

Even if you're an experienced parent, you may feel anxious and unsure. Remember that parenting in the NICU is different and challenging. It's natural to feel like a beginner as you learn how to meet your baby's unique needs.

Be patient with yourself when you feel awkward or hesitant. Nobody expects you to be comfortable with your baby right away. Give yourself the time you need to adjust and feel more confident with your baby.

If you are afraid to make mistakes or show your inexperience, you may find yourself backing away from your baby. Try telling your baby's nurses that you’re unsure of yourself. They can give you the support and practice you need to become skilled at taking care of your baby.

When to seek professional counseling

It's normal to experience a range of emotions and changes in behavior while your baby is in the NICU. But you may find it difficult to deal with some of these feelings. You can benefit from seeing a professional counselor if:

You think it may help you feel better

Your ability to cope with the situation is not improving and you feel stuck

You continue to find no joy in other parts of your life

You have trouble with your relationship with your partner or others close to you

You feel a parent support group isn"t "quite enough"

You should talk to a professional counselor if:

You feel prolonged numbness or detachment

You continue to feel detached from your baby

You have trouble getting out of bed or starting your day

You feel unable to cope or manage your other responsibilities

You think about harming yourself or others

Your doctor or the hospital social worker can refer you to a counselor who understands the trauma of having a baby in the NICU. Even just a couple of visits might give you the reassurance and boost you need.

Postpartum reactions

New moms may be experience some degree of postpartum adjustment or depression. As your body recovers from pregnancy, physical and hormonal changes may intensify your emotions for many months after delivery.

If you can't seem to shake uncomfortable feelings such as anxiety, sadness, fatigue, irritability, hopelessness or disinterest, tell someone close to you --your partner, a friend, a family member--that you are having a difficult postpartum adjustment and you need them to help you. Let them help you get what you need, including an appointment with a health care provider who takes your symptoms seriously.

Medical emergencies

If a new mother experiences confusion, hallucinations or delusions, and/or thoughts of hurting herself or others, this is a medical emergency. Seek immediate medical attention.

If you are feeling so badly that you are considering suicide, this is a medical emergency. Have your partner, friend or family member bring you to the emergency room of a local hospital or call 911. You deserve to get the help you need.

Excerpted from the March of Dimes booklet, "Parent: You & Your Baby in the NICU," written in collaboration with Deborah L. Davis, PhD and Mara Tesler Stein, PsyD, authors of "Parenting Your Premature Baby and Child: The Emotional Journey."

Confused about all the people caring for your baby in the NICU? Find out who's who.

Frequently Asked Questions

Is it OK to hold my baby in the NICU?

It depends on your baby's health overall. Some newborn intensive care units (NICUs) will encourage you to hold your baby from birth onward. Other NICUs will want you to wait until your baby's health is stable. Ask your NICU staff about its policy on kangaroo care (holding your baby on your bare chest). Kangaroo care has benefits for both you and your baby. The skin-to-skin contact is a precious way to be close to your baby. You may be afraid you'll hurt him by holding him. But you won't. Your baby knows your scent, touch and the rhythms of your speech and breathing, and he’ll enjoy feeling that closeness with you.

My baby was born full term. Why is she in the NICU?

Not all newborn intensive care unit (NICU) babies are born premature. Some babies, even those born full term, may need special care. Your baby may need to spend some time in the NICU if she had a difficult delivery, has breathing problems, has infections or has birth defects.

Most babies leave the NICU just fine. Others may need more special care once they're home.

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